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Brain Injury (BI) Waiver

Page posted: 10/1/03

Page reviewed: 4/16/13

Page updated: 1/31/19

Legal authority

Federally approved BI Waiver Plan, Minn. Stat. §256B.093, Minn. Stat §256B.49


Effective with the waiver renewal April 1, 2011, the name of this waiver changed from Traumatic Brain Injury to Brain Injury to accurately reflect the people eligible for this program. Please note you may continue to see references to the TBI Waiver in various forms, documents and CBSM pages as we work on implementing the name change. Thank you for your patience as we continue with these updates.


Brain Injury (BI) Waiver: Home and community-based services necessary as an alternative to institutionalization that promote the optimal health, independence, safety and integration of a person who would otherwise require the level of care provided in a specialized nursing facility or neurobehavioral hospital.


To be eligible for the BI Waiver, a person must choose the BI Waiver and meet all of the following criteria:

1. Eligible for Medical Assistance (MA)

2. Certified disabled by Social Security or the State Medical Review Team (SMRT)

3. Younger than age 65 at the time of opening to the waiver

4. Determined by the case manager/service coordinator to meet one of the following level of care criteria:

  • • Nursing facility (BI-NF)
  • • Neurobehavioral hospital (BI-NB)
  • 5. Have a completed BI Waiver Assessment and Eligibility Determination DHS-3471 (PDF)

    6. Diagnosed with one of the following documented diagnoses of brain injury or related neurological condition that resulted in significant cognitive and behavioral impairment:

  • • Acquired or traumatic brain injury that is not congenital
  • • Degenerative or genetic disease where cognitive impairment is present, becomes symptomatic on or after the person’s 18th birthday and is not congenital
  • 7. Have the potential to benefit from rehabilitative services as determined by a Ranchos Los Amigos score of IV or above

    8. Have an assessed need for supports and services over and above those available through the MA state plan

    9. Have an assessed need for one or more of the following:

  • • Specialized provider with experience or expertise appropriate to meet the person's cognitive or behavior impairments
  • • Higher amount of units or rate for services due to cognitive or behavior impairments.
  • Covered services

    The following services are covered under the BI Waiver. For a service-specific policy page, select a service from the list:

  • 24-hour emergency assistance
  • Adult companion services
  • Adult day services (includes family adult day services)
  • Adult day services bath
  • Behavioral support
  • Caregiver living expenses
  • Case management/service coordination
  • Case management aide
  • Chore services
  • Consumer directed community supports (CDCS)
  • Crisis respite
  • Customized living
  • Customized living 24-hour
  • Employment development services
  • Employment exploration services
  • Employment support services
  • Environmental accessibility adaptations
  • Extended home care services
  • Family training and counseling
  • Foster care
  • Home-delivered meals
  • Homemaker
  • Housing access coordination
  • In-home family supports
  • Independent living skills (ILS) training
  • Individualized home supports
  • ILS therapies
  • Night supervision services
  • Personal support
  • Prevocational services
  • Residential care services
  • Remote support – Individualized home supports and supported living services for adults in own home
  • Respite
  • Specialist services
  • Specialized equipment and supplies (includes personal emergency response systems [PERS])
  • Structured day program
  • Supported employment services
  • Transitional services
  • Transportation.
  • Local waiver program administration

    Local county or tribal administration acting as agents for the state Medicaid agency and DHS have many responsibilities. See the state and county/tribal responsibilities for waiver management section on CBSM – Waiver programs overview.

    Waiver forms

    For a comparison grid of forms applicable across and/or specific to waiver programs, see CBSM – Required waiver forms.

    Process and procedure

    See CBSM – BI, CAC, CADI and DD waiver general process and procedure for specific information about:

    Additional resources

    Brain Injury (BI) Waiver Program brochure, DHS-3442 (PDF)
    CBSM – Instructions for completing the physician letter of medical necessity for the BI-NB Waiver

    CBSM – Waiver/AC provider enrollment and standards

    CBSM – Waiver general process and procedures (BI, CAC, CADI, DD)

    CBSM – Waiver programs overview

    CBSM – Waiver rates and billing

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